Single versus double insemination: a retrospective audit of pregnancy rates with two treatment protocols in donor insemination

Abstract

Our objective was to evaluate the effect of a change in treatment protocols, suggested following an inspection visit by the regulatory authority, from single to double inseminations during donor insemination treatment cycles. We therefore conducted a retrospective audit of pregnancy rates in the reproductive medicine clinic of a major teaching hospital. All patients were treated for male factor infertility by donor insemination, without ovulation induction with gonadotrophins between October 1992 and December 1995. The main outcome measures were cumulative conception and live birth rates. During the study period 250 patients underwent treatment and 650 single insemination and 277 double insemination treatment cycles were undertaken. The pregnancy rate per cycle was 0.054 and 0.119 for single and double insemination respectively. After six cycles the cumulative pregnancy rates were 0.28 and 0.47 and the take-home baby rates were 0.25 and 0.37 for single and double inseminations respectively. The change in practice from single to double insemination resulted in a doubling of the pregnancy rate per treatment cycle. Cumulative pregnancy rates after two treatment cycles of double insemination were comparable with those achieved after six cycles of single insemination. These results have significant implications for both patients and purchasers.

Donor Sperm Insemination Cycles: Are Two Inseminations Better Than One?

“…The literature that addresses this specific question in donor sperm frozen‐thawed insemination cycles is limited and conflicting. A few studies using either natural cycles or ovarian stimulation showed benefit from double inseminations (Centola et al, 1990; Deary et al, 1997; Matilsky et al, 1998) and 1 study did not show any benefit (Khalifa et al, 1995). Two of these studies, however, compared single vs double ICIs (Centola et al, 1990; Deary et al, 1997).…”

“…A few studies using either natural cycles or ovarian stimulation showed benefit from double inseminations (Centola et al, 1990; Deary et al, 1997; Matilsky et al, 1998) and 1 study did not show any benefit (Khalifa et al, 1995). Two of these studies, however, compared single vs double ICIs (Centola et al, 1990; Deary et al, 1997). One prospective study using frozen‐thawed donor sperm demonstrated a 2‐fold probability of conception over 15 cycles in patients who received double IUI (Matilsky et al, 1998).…”

Correlation between the times of IUI and pregnancy outcome: a systematic review and meta-analysis with trial sequential analysis of cohort study

“…Table 2 summarizes the characteristics of a total of 54208 IUI cycles (excluding 32 cycles of lost visits) with 7773 clinical pregnancy outcomes in these 23 studies. Deary 1997 [19] (1992-1995) Hill 2013 [21] ( Monseur 2019 [24] (1999-2017) Guo Yu-rui 2016 [29] ( Yin Ming-na 2014 [30] ( Li Jing 2010 [32] ( Li Si-Chen 2016 [33] ( Li Hong-xia 2020 [34] ( Li Jing 2014 [35] (2012-2013) Wang Gang 2017 [37] ( Guo Jianghua 2007 [39] (…”

How to Perform the Best Intrauterine Insemination? A Review

“…Importantly, most of the studies analyzed homologous IUI, however, some studies compared one versus two donor inseminations. The first articles are in favor of double insemination [88], including those where frozen-thawed donor sperm was used [89,90], while current studies are against double IUI, showing similar clinical pregnancy rates in both groups and proving no double IUI cycles are needed when donor sperm is used [91,92].…”